UCAOA Lifetime Membership Award
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Lifetime Membership Award


Significant contributions of an individual to UCAOA are recognized with awarding of lifetime membership. The awardee will be granted complimentary lifetime membership in UCAOA as well as complimentary registration to the UCAOA Urgent Care Convention & Expo the year he or she receives the award.

Before completing the form, please ensure that the nominee meets the following criteria:

  • Nominee must be a UCAOA member for more than five years
  • Nominee must demonstrate impeccable service to the association
  • Nominee has shown active participation in UCAOA committees, volunteer programs, and events
  • Nominee cannot be a current member of the UCAOA Awards Committee nor Board of Directors


  • All required fields are marked with a red asterisk (*)
  • Any field name that is underlined has additional instructions/details. Position your cursor over the underlined questions to view details.   
  • Please do not nominate one person for multiple categories. The Awards Committee can determine if the nominee is eligible for more than one award. 
  • Deadline to Nominate: November 20, 2017
  • If you have questions, please send an email to nshah@ucaoa.org 


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